Means for ligating arteries



March 4, 1930. I RHSLER 1,749,261

MEANS FOR LIGATING ARTERIES Filed June i928 tying .a' suitable double knot Patented Ma 1:(4,f1930 fsrivroiv REVISLER, or lINDIANAPOLIS, INDIANA,

EANS For. ILIGATING ARTERIES Application'filedlune4, 1923. Serial No. 282,573.

. ctjofilfis invention to seize and securely ligate a blood vessel at a distance ln accessible to the reach; of the fingers durlng surgical operations, ljperforming the: act of similar to one tiedrwith'thefingers. I

ob 'ect of the; invention is to transfer a looppreviously applied over a hemostat', andvrtie; it securely over. the tissues 1 caught by theheinostat, thentightena second loop over thefirstythus making adoubleknot which .-securely holds'th bloodvessel.;-

I :Ij'ac'complish.the above and'other minor objectsjwhich will hereinafter. appear, by the means illustrated in w the accompanying drawjririgdn Which?- I.

f Fig. ;1 'isja'top plan view of my apparatus xth fi' k i 5f F'gi- 3,-shows.a 1n ajor port-ion ofthety ng "threaded-and ready forusejby the surgeon. f y "Fig. 2;, shows the: same with the artery, graspedan'd' being held; the ligature being positionedj'around the artery, with the tying rnechanism of the apparatus in position to ghten the ligatureon the. artery and tighten mechanism or unit only; with the thread Lcont'a'ct-ing en ds ot the legs crossedtogether I i0 easetheithreadfrom theei dhooks.

Eige is a topplan view I of the hernostat ththetying c ni m BmQ Fig, 5 is a fragment] of the mechanism f f shown in Fig, .3 ifturned }upside'down.'

is ac t 'on on th li +6 rigtll-m:

41 a. i -YZ i QI ise t Q 0n 1 'l Q' fll i 8 i of the spring plate I ning;fi getherjthetwo legsof the tying Fig. 9iis'a perspectiveview of t iit tyechanism. positioned as shown from the j Likech'aractersofreference indicate like L V o {par s inflthe several; views' ofthe' drawings.

d o a ysg r y 5w e ied SW1? es that shownat10,is grasped securely between the, jaws 11,11,015 a hemostat preferably toothed to increase the hold. The power arms .12 of the hemostat are very long comparatively. *Thegrip' on the artery is'retained bya suitable lock 13, here shown as a pair of interlocking hooks, see'Fig. 7, of the pressure release type that locks withpressure of the hand and releases by a further pressure.

,Onefof the arms 12 has an inside extension 14' formed with a slot 15 longitudinally of the arm and terminating at its inner end with. an-enlargement 16, for the passage througlithe slotof the flangedend of a lug m 17, alined with a pivotl8, and preferably integral therewith, which connects the two legs-21 and 22, of 'apair of l not tyinglever's slidinglyheld by and on the hemostat.

The power. arms 19 and 20 of the tying levers are shorter than the legs and' are curved away from each other and terminate with finger-loops 23. The power arms are bent and positioned.so tliey can cross each other insteadofcontactingwhen pressed together, in .-order to increase the outward movement oi the ends of their legs as shown in Fig. 2,- and push the loop outof the hooks.

. The legs .Qland 22 have bends 24'which o flset' the ends inwardly or toward each other so the offset portions will cross preferablyto the extent shown in Fig. 3; which is suflicient ,to force the loop of thread out of the hooks. This is regulated by contact of the two legs with each other at. 25. But should it be desirable to cross the legs further that is readily accomplished by making the bends 24 closerto the pivotal point of the, legs.

:The, legs 21 and22 terminate with hooks.

26" opening outwardly,'and adjacent thereto are eyes 27 One of the finger loops '23 has a spring clamp 28 to hold theends of the threadas shownin Figs. 1 and 2. Pivot ed atone of its ends to theleg2l is a curved spring plate 29 which is; set to press against the leg 22 atits other end. This last end is camfaced on itscontacting side, see Fig. 8,

to increase its frictional engagement ithhold the knot-tying member steadily and firmly. Then the threadends are" crossed through the hooks for a second single knot (see Fig. 9), and are then threaded through the eyes 27 and are drawn taut and are fastened under the spring-clamp 28;

The instrument thus prepared, usually an assistant, is readyv for use by the surgeon who grasps the four :loops with his tlaunib andthree fingers and inserts the j aws into the cavity, firmly grasps theiend of theartery to be tied between the jaws a spreading movement o f the-{loops 2-3, and locks the instrum'ent-on the artery by theaidiof'the pressure, release lock 1 3 1 Y Then changing the loops 23' tothe :left. hand While holding those of the-tyingwrlevice in "the rightih an'd the l operator pushes the loopof tl-iread around the h'emostat, ofi of the latter upon' the artery and 7 draws the first knot tight by spreading the: legs 21 V and 22 apart approximately to the positionsh-own in Fig; 2.;- "Then the thread is disengaged from the h ooks- '26 by carryin g the legs to theiposi tion-shoWn-"In F ig. 3,- which leaves the thread threadedfthroug lr the ;eyes:fl27- and. crossed betweenithe eyes-ready to finish theftieof a double knot by ti ghtening up the thread ends hel d i -n- '28, and then again spreading,

the legs e2l and 22 "apart; This comfp'le'tes-the tying'of a double knot of the same character "matter of its use; I 'WhileI have shown, and described a pre-' as is nsu allly tied by hand in ligatingarteries.

My-inventionis useful in tying other than arteries and I do not desire to limit itin the cise form of my invention it is capable of modifications, Without departing from the spirit thereof and; I therefore do not desire to V be limited to the form, and operation-shown,

anymore than is required" by the appended claims, and having thus fully 'disclo sed; my

invention vvha t claim is i 1; In, a ligating instrument, =1neans for graspingflan end be a' member) to be tied, a

threadlo'op'eid around said grasping means and crossedlto form a second floo pffor a double knot, means for, grasping the thread initiie lsecond' 'loop, means for'ggrasping it I .ibeyond the second "loop, means for transfer- -;ring the loopsjfiomsthe' grasping-means to th'emenibei to be" tied, means for consecutively tightening the two l'oops having a spreading action in one direction to tighten one of the loops on themember and having a spreading actionin a reverse direction to i release the first loop and'engage the-second loop for tightening into a double knot with the first loop. V

2; The combination with a hemostat having a longitudinal slot, of aknot tying device having a lug movable longitudinally in the slot and removable therefronnsaid knot- V tying device comprising a pairof pivotally united levers.

3. The combinationwith a' hemostat, of a knot tying device movable longitudinally thereof to transfer'two loops previously ap' .pl-iedrto-them from thehemosta-tto the object to be tied,.said tying device having a spreading action in oneidinection to tighten one of the loops on the object andhavinga spreadi-ng action in a reverse direction; te'rel'ease' V -leopfer tightening'into r agdouble the secon knot with-the fi rstloop.

4. "The--combination with a hemostaty-ioif ia r knot tying device movable longitudinally plied to them from the hemostwt 'toi the object s to; be tied, said tying device;having.5a spread action in one direction:'to tiglaten one of "tlie'flo'opjs on j-th'e objeetgandhhavingasspnead ing action in=areverse :di ct-1on to release the I second 10 p for tighteninginto a durable knot'w'ith thei first loop,-;an d then byagjain r spreading* the device to} tighten the second loop with the first'into'adenble k not: a 5. The combination With"a hfemOStat of means adjiustably" I removably seoured thereto; *for transferring: two previously 7 formed-loops from them to -jan objected be tried to form a dinible; knot," said lastmeans H yingg-the two j having; means for :-sueeessiv 1y transfer-red loopsinto" a dou bl knot "-6. T he combination meh.ia'hemgaeior 7 means for transferring-two previously I. 1

formed loops from them? to objectto be tied toprovide a doublea k not and-means for Y 'suecessrvelytying'thetwo transferred loops.

intoa double knot by a spreading action of i the last {means fol-lowed; by! areversing and v crossing-action and tl len by a-se'eond' spr'eadk lngac-non.

I 7. The came-masonwith -a;hemostat of means for-transferring- "two previously formed loopsfrom them to an object to, be i the other for tying a double knot, andnne'ans for SuQQQSSiVeIy"tying'the twortra lsv ferred loopsbya-spreadingactionof ie lagst means T i tied, one loop to sur r-oun'd the object and followed by a reversing and eres n-g action and t henby;a second spreadingjactijon, com; prising a p air of pivotedlegs-eachhav eye and an end. hook beyon the threadis held '85. The combiantion 'ing {the object to'be-iitied, *sarc means 0 holdmeanshaving"a V 7 e0 thereof to transfer two l oops previouslyap;

its

v slotyo f a knot tying device slidingly and re movably secured in the slot, said device como prising a pair of pivoted legs each having a manipulating arm. at one end and an eye and adjacent hook at the other. end in Which eyes and hooks the thread previ'ouslyapplied in a double loop is held, one of the loops passing initially around the object-holding means while the other is simultaneously placed in position for tying a double knot. Q

In testimony whereof I affix' my signature.

' SIMON REI SLER.- 

